Understanding Childhood Leukaemia

Types of Leukaemia in Children

Leukaemia is a form of cancer that affects white blood cells, characterised by the uncontrolled proliferation or multiplication of abnormal white blood cells in the bone marrow.

In children, the two primary types of leukaemia that are commonly diagnosed are Acute Lymphoblastic Leukaemia (ALL) and Acute Myeloid Leukaemia (AML).

The most common form of childhood leukaemia is ALL thataffects lymphocytes, a type of white blood cell. It progresses rapidly if left untreated, but with early intervention, the prognosis is generally positive.

On the other hand, AML targets myeloid cells which are responsible for producing red blood cells, other white blood cells, and platelets. Like ALL, AML progresses quickly and requires immediate treatment.

Risk Factors for Childhood Leukaemia

The exact cause of childhood leukaemia remains largely unknown, though it is understood that genetic changes in bone marrow cells contribute to the development of the disease.

While the precise causes are unclear, several risk factors may increase the likelihood of a child developing leukaemia. Children and young adult with genetic conditions, such as Down syndrome, have a higher risk of developing leukaemia. Although rare, a family history of leukaemia or other cancers may raise a child’s risk. High levels of ionising radiation, such as that used in cancer treatments, can increase the risk of childhood leukaemia.

Symptoms

Symptoms of childhood leukaemia can be challenging to detect, as they may mimic those of common illnesses. It is crucial to monitor any persistent or unusual symptoms, such as:

• Anaemia: Signs include fatigue, pale skin, dizziness, and shortness of breath due to a low red blood cell count.
• Infections and fever: A weakened immune system from low white blood cell counts can lead to frequent infections and fevers.
• Easy bruising and bleeding: Reduced platelet counts can cause easy bruising and prolonged bleeding.
• Swollen lymph nodes: Enlarged lymph nodes may appear in various parts of the body.
• Abdominal pain: Stomach aches due to swelling of the liver or spleen.
• Bone pain: Pain in the bones and joints.
• Unexplained weight loss: A sudden or unexpected loss of weight can be an indicator.
• General unwellness: A persistent feeling of being unwell without a clear cause.

For children with darker skin tones, some symptoms like pale skin and bruising may be less obvious. It is often easier to observe these symptoms in areas such as the lips, gums, tongue, and nail beds.

Diagnosing Leukaemia in Children

A series of tests and examinations is necessary to confirm a leukaemia diagnosis and identify the type and severity of the disease. These typically include:

• Blood tests: A full blood count and blood smear are usually the first tests conducted.
• Bone marrow aspiration and biopsy: A sample of bone marrow is taken to examine the presence of cancerous cells and determine the type of leukaemia.
• Genetic testing: Identifies genetic changes in the leukaemia cells to help doctors select the most effective treatment and understand the child’s prognosis.
• Lumbar puncture: Extracts cerebrospinal fluid to check for leukaemia cells in the brain or spinal cord and can also administer chemotherapy to prevent the spread of the disease.
• Imaging tests: X-rays, CT scans, MRI, PET-CT scans, or ultrasounds may be used to check for signs of leukaemia in the chest or other organs.

Treatment Options

The treatment plan for leukaemia depends on factors such as the type of leukaemia, the child’s age, overall health, and how far the disease has progressed.

• Chemotherapy: The primary treatment method, chemotherapy involves the use of drugs to kill cancer cells.
• Radiation therapy: Less commonly used but may be employed to prevent or control the spread of leukaemia to the brain or testicles.
• Targeted therapy: Utilises drugs that specifically target abnormal proteins or genetic mutations in the leukaemia cells, sparing healthy cells.
• Immunotherapy: Strengthens the immune system to help it identify and attack cancer cells.
• Stem Cell Transplant (SCT): Also known as a bone marrow transplant, SCT may be used to enable doctors to administer higher doses of chemotherapy. This is sometimes necessary for more aggressive forms of leukaemia.

Supporting a Child with Leukaemia

Caring for a child with leukaemia involves emotional and practical support throughout their treatment journey. It is important to reassure your child, provide comfort, and offer age-appropriate explanations about their treatment. Be attentive to their emotional needs, listen actively, and validate their feelings.

Practical support includes staying organised with appointments, medications, and treatments, ensuring your child maintains a nutritious diet to support their strength and recovery, and involving them in playful or creative activities to help them cope. Therapy or counselling for both the child and the family can also be beneficial during this challenging time.

Post-Treatment Considerations

After treatment, your child’s immune system may remain compromised, making them more vulnerable to infections such as measles, chickenpox, and shingles. It is important to avoid exposure to these infections and closely monitor any new symptoms that may arise. Contact a doctor immediately if your child shows signs of infection, such as:

• A high temperature (38°C or higher).
• A cough or sore throat.
• Confusion or unusual behaviour.
• Redness, swelling, or pain in any area.
• Rapid heartbeat or breathing.
• Unexplained fatigue or weakness.
• Painful or frequent urination.
• Diarrhoea or vomiting.

Book an Appointment at Gleneagles Hospitals

If you suspect that your child is exhibiting any leukaemia symptoms, get in touch with us to find out more about our Paediatrics and Oncology services at your nearest Gleneagles Hospital.